circulatory and cardiovascular systems
DESCRIPTION
Circulatory and Cardiovascular Systems. Spring 2013. Circulatory System. Blood Vascular System. Heart and Great Vessels. Cross Section of the Heart. Arteries of the Heart. Anterior View of Coronary Arteries. Anterior View of Coronary Veins. Congenital Heart Diseases Murmur - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/1.jpg)
Circulatory and Circulatory and Cardiovascular Cardiovascular
SystemsSystemsSpring 2013Spring 2013
![Page 2: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/2.jpg)
22
Circulatory SystemCirculatory System
![Page 3: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/3.jpg)
33
Blood Vascular SystemBlood Vascular System
![Page 4: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/4.jpg)
44
Heart and Great VesselsHeart and Great Vessels
![Page 5: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/5.jpg)
55
Cross Section of the HeartCross Section of the Heart
![Page 6: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/6.jpg)
66
Arteries of the HeartArteries of the Heart
![Page 7: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/7.jpg)
77
Anterior View of Coronary Anterior View of Coronary ArteriesArteries
![Page 8: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/8.jpg)
88
Anterior View of Coronary Anterior View of Coronary VeinsVeins
![Page 9: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/9.jpg)
99
Pathologies Pathologies Congenital Heart Congenital Heart
DiseasesDiseases– MurmurMurmur– Patent Ductus ArteriosusPatent Ductus Arteriosus– Arterial Septal DefectsArterial Septal Defects– Ventricular Septal Ventricular Septal
DefectsDefects– Teratology of FallotTeratology of Fallot
Valvular heart diseaseValvular heart disease– Valvular StenosisValvular Stenosis– Congestive Heart FailureCongestive Heart Failure
Degenerative diseasesDegenerative diseases– CADCAD– AtherosclerosisAtherosclerosis
Myocardial infarctionMyocardial infarction Aortic aneurysmAortic aneurysm Pulmonary EmbolismPulmonary Embolism
![Page 10: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/10.jpg)
MurmurMurmur Murmur- an Murmur- an
abnormal heart abnormal heart soundsound– Results from Results from
malformed valvesmalformed valves
![Page 11: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/11.jpg)
Patent Ductus ArteriosusPatent Ductus Arteriosus
1111
![Page 12: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/12.jpg)
Atrial Septal DefectAtrial Septal Defect
1212
![Page 13: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/13.jpg)
Ventricular Septal DefectVentricular Septal Defect
![Page 14: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/14.jpg)
Teratology of FallotTeratology of Fallot
![Page 15: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/15.jpg)
Coarctation of the AortaCoarctation of the Aorta
![Page 16: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/16.jpg)
Valvular DiseaseValvular Disease
1616
![Page 17: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/17.jpg)
Mitral Valvular StenosisMitral Valvular Stenosis
![Page 18: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/18.jpg)
Mitral Valve StenosisMitral Valve Stenosis
![Page 19: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/19.jpg)
Congestive Heart FailureCongestive Heart Failure
![Page 20: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/20.jpg)
CHF RadiographCHF Radiograph
![Page 21: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/21.jpg)
Coronary Artery DiseaseCoronary Artery Disease
![Page 22: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/22.jpg)
Coronary Artery DiseaseCoronary Artery Disease
![Page 23: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/23.jpg)
Myocardial InfarctionMyocardial Infarction
![Page 24: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/24.jpg)
Myocardial Infarction Myocardial Infarction ImagesImages
![Page 25: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/25.jpg)
Aortic AneurysmAortic Aneurysm
![Page 26: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/26.jpg)
Aortic Aneurysm ImagingAortic Aneurysm Imaging
![Page 27: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/27.jpg)
2727
AortogramAortogram
![Page 28: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/28.jpg)
2828
![Page 29: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/29.jpg)
2929
AORTOGRAMAORTOGRAM
![Page 30: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/30.jpg)
3030
Abdominal AortoraphyAbdominal Aortoraphy
![Page 31: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/31.jpg)
3131
Abdominal AngiographyAbdominal Angiography
![Page 32: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/32.jpg)
3232
AAA Pre and Post Stent AAA Pre and Post Stent PlacementPlacement
![Page 33: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/33.jpg)
3333
![Page 34: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/34.jpg)
3434
Abdominal StentAbdominal Stent
![Page 35: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/35.jpg)
3535
AAAAAA
![Page 36: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/36.jpg)
Pulmonary Pulmonary EmbolismEmbolism
![Page 37: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/37.jpg)
Pulmonary Embolism Pulmonary Embolism ImagingImaging
![Page 38: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/38.jpg)
Angiography Angiography Arteriography and Arteriography and
AortogramsAortogramsSPRING 2013 SPRING 2013
![Page 39: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/39.jpg)
AngiographyAngiography
Is the general term that Is the general term that describes the radiologic describes the radiologic examination of vascular examination of vascular
structures within the body structures within the body after the introduction of an after the introduction of an
iodinated contrast medium or iodinated contrast medium or gasgas
![Page 40: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/40.jpg)
4040
Types of Angiographic Types of Angiographic ProceduresProcedures
![Page 41: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/41.jpg)
4141
![Page 42: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/42.jpg)
4242
Angiography TeamAngiography Team RadiologistRadiologist
CIT (Radiologic Technologist)CIT (Radiologic Technologist)– Sometimes more than oneSometimes more than one
Other specialists (if needed)Other specialists (if needed)
Nurse Nurse
Anesthesiologist (if needed)Anesthesiologist (if needed)
![Page 43: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/43.jpg)
4343
IndicationsIndications Verify the presence of Verify the presence of
tumorstumors– Blood supply to tumorsBlood supply to tumors
Internal bleedingInternal bleeding– Possible anemiaPossible anemia
StenosisStenosis
– Can be caused form Can be caused form atherosclerosisatherosclerosis
OcclusionsOcclusions– ClotsClots– ThrombusThrombus– EmbolusEmbolus
AneurysmsAneurysms
Heart diseaseHeart disease
![Page 44: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/44.jpg)
4444
ContraindicationsContraindications Previous severe reaction to contrast Previous severe reaction to contrast
Impaired renal functionImpaired renal function
Impaired blood clotting factorsImpaired blood clotting factors
Inability to undergo surgical procedureInability to undergo surgical procedure
![Page 45: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/45.jpg)
4545
Contrast MediaContrast Media Iodinated contrast media is usedIodinated contrast media is used
– Can produce nausea & an Can produce nausea & an uncomfortable burning sensationuncomfortable burning sensation
– Allergic reactionsAllergic reactions Severe: anaphylactic shockSevere: anaphylactic shock
– Shock, rapid shallow breathing, high pulse rate & Shock, rapid shallow breathing, high pulse rate & ALOCALOC
Mild: Hives or slight difficulty breathingMild: Hives or slight difficulty breathing
![Page 46: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/46.jpg)
4646
What is this?What is this?
![Page 47: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/47.jpg)
4747
![Page 48: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/48.jpg)
4848
Angiographic Trays Angiographic Trays and Sterile Suppliesand Sterile Supplies
![Page 49: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/49.jpg)
4949
Other Supplies for Other Supplies for AngiographyAngiography
![Page 50: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/50.jpg)
5050
NeedlesNeedles Vascular access Vascular access
needlesneedles Size based on Size based on
external diameter of external diameter of needleneedle
Allows for Allows for appropriate appropriate Guidewires matchingGuidewires matching– So internal diameter So internal diameter
must also be knownmust also be known
![Page 51: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/51.jpg)
5151
GuidewiresGuidewires Used as a platform Used as a platform
over which a catheter over which a catheter is to be advancedis to be advanced
Once positioned Once positioned guidewire is fixed and guidewire is fixed and catheter is advanced catheter is advanced until it meets the tip until it meets the tip of the guidwireof the guidwire
Mostly constructed on Mostly constructed on stainless steel & stainless steel & coated with Tefloncoated with Teflon
![Page 52: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/52.jpg)
5252
Introducer SheathsIntroducer Sheaths Short catheters Short catheters
used when multiple used when multiple catheters will be catheters will be usedused
Placed in lieu of a Placed in lieu of a cathetercatheter
![Page 53: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/53.jpg)
5353
CathetersCatheters
![Page 54: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/54.jpg)
5454
![Page 55: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/55.jpg)
5555
DSA DSA A subtraction mask is A subtraction mask is
taken before contrast taken before contrast injectedinjected
Each of digitized Each of digitized image is from the image is from the maskmask
Images acquired Images acquired formform– 1 image every 2-3 sec1 image every 2-3 sec– Up to 30 images per Up to 30 images per
secsec
![Page 56: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/56.jpg)
5656
Three Dimensional (3-D) Three Dimensional (3-D) Intraarterial AngiographyIntraarterial Angiography
![Page 57: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/57.jpg)
5757
What Method is this?What Method is this?
![Page 58: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/58.jpg)
5858
Catherization: Selinger Catherization: Selinger TechniqueTechnique
![Page 59: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/59.jpg)
5959
Selinger Technique Catheters Selinger Technique Catheters and Guidewiresand Guidewires
![Page 60: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/60.jpg)
6060
Radiation ProtectionRadiation Protection PT is protected by no less than 2.5 PT is protected by no less than 2.5
mm of Aluminummm of Aluminum Beam restrictionBeam restriction Avoidance of repeat exposureAvoidance of repeat exposure Cardinal rulesCardinal rules
– Time Time – DistanceDistance– ShieldingShielding
![Page 61: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/61.jpg)
6161
Stent PlacementStent Placement http://images.google.com/imgres?http://images.google.com/imgres?
imgurl=http://www.nhlbi.nih.gov/health/dci/imgurl=http://www.nhlbi.nih.gov/health/dci/images/stent_restenosis.gif&imgrefurl=http://images/stent_restenosis.gif&imgrefurl=http://www.nhlbi.nih.gov/health/dci/Diseases/stents/www.nhlbi.nih.gov/health/dci/Diseases/stents/stents_all.html&usg=__xDlbsaX9JhuYbpVojLcz1stents_all.html&usg=__xDlbsaX9JhuYbpVojLcz19apr-9apr-I=&h=513&w=450&sz=59&hl=en&start=20&tI=&h=513&w=450&sz=59&hl=en&start=20&tbnid=vWwqaG-RNW7M-bnid=vWwqaG-RNW7M-M:&tbnh=131&tbnw=115&prev=/images%3FqM:&tbnh=131&tbnw=115&prev=/images%3Fq%3Dabdominal%2Bstents%26gbv%3D2%26hl%3Dabdominal%2Bstents%26gbv%3D2%26hl%3Den%3Den
![Page 62: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/62.jpg)
6262
Pulmonary CirculationPulmonary Circulation
http://www.youtube.com/watch?v=D3ZDJgFDdk0
http://www.youtube.com/watch?v=0jznS5psypI
![Page 63: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/63.jpg)
6363
Pulmonary ArteriogramPulmonary Arteriogram
![Page 64: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/64.jpg)
Celiac AteriogramCeliac Ateriogram
Celian artery carries Celian artery carries blood from stomach to blood from stomach to duodenum, liver, duodenum, liver, spleen and pancreasspleen and pancreas
Approx at level T12Approx at level T12
6464
![Page 65: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/65.jpg)
Hepatic ArteriogramHepatic Arteriogram
6565
![Page 66: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/66.jpg)
Splenic Splenic ArteriorgramArteriorgram
6666
![Page 67: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/67.jpg)
6767
Renal ArteriogramRenal Arteriogram
![Page 68: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/68.jpg)
6868
renalrenal
![Page 69: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/69.jpg)
6969
![Page 70: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/70.jpg)
7070
![Page 71: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/71.jpg)
7171
![Page 72: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/72.jpg)
7272
Lower Limb ArteriesLower Limb Arteries
![Page 73: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/73.jpg)
7373
![Page 74: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/74.jpg)
7474
Leg AtherosclerosisLeg Atherosclerosis
![Page 75: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/75.jpg)
7575
Atherosclerosis Left LegAtherosclerosis Left Leg
![Page 76: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/76.jpg)
7676
Upper Limb ArteriesUpper Limb Arteries
![Page 77: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/77.jpg)
7777
Upper Extremity AnatomyUpper Extremity Anatomy
![Page 78: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/78.jpg)
7878
Brachial and Axillary Brachial and Axillary ArteriogramArteriogram
![Page 79: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/79.jpg)
7979
Hand ArteriogramHand Arteriogram
![Page 80: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/80.jpg)
8080
Hand Arteriogram with Hand Arteriogram with OcclusionOcclusion
![Page 81: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/81.jpg)
8181
![Page 82: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/82.jpg)
8282
Balloon AngioplastyBalloon Angioplasty
![Page 83: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/83.jpg)
8383
![Page 84: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/84.jpg)
8484
Balloon Angioplasty Balloon Angioplasty ProcedureProcedure
![Page 85: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/85.jpg)
8585
Femoral Artery AngioplastyFemoral Artery Angioplasty
![Page 86: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/86.jpg)
8686
Placing a Stent after Placing a Stent after Angioplasty with BalloonAngioplasty with Balloon
![Page 87: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/87.jpg)
8787
Intravascular StentsIntravascular Stents
![Page 88: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/88.jpg)
Cerebral Angiography Cerebral Angiography IndicationsIndications
• AneurysmsAneurysms
• Arteriovenous MalformationsArteriovenous Malformations
• TumorsTumors
• Athersclerotic LesionsAthersclerotic Lesions
• Stenotic lesionsStenotic lesions
![Page 89: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/89.jpg)
Circle of WillisCircle of Willis
![Page 90: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/90.jpg)
Circulation Time Circulation Time Cerebral circulationCerebral circulation
Carotid artery to jugular vein (3 seconds)Carotid artery to jugular vein (3 seconds) With contrastWith contrast
– 4.13 seconds4.13 seconds Certain pathologies shorten or delay Certain pathologies shorten or delay
timetime– AVM’s shorten timeAVM’s shorten time– Arterial vasospasm delays timeArterial vasospasm delays time
![Page 91: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/91.jpg)
EquipmentEquipment Bi-plane imagingBi-plane imaging
– FilmFilm– DSADSA
Automatic InjectorAutomatic Injector
![Page 92: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/92.jpg)
Carotid AngiogramCarotid Angiogram
![Page 93: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/93.jpg)
Internal Carotid AngiogramsInternal Carotid Angiograms
![Page 94: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/94.jpg)
Internal Carotid AngiogramInternal Carotid Angiogram
![Page 95: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/95.jpg)
Vertebral Arteries Vertebral Arteries AngiogramAngiogram
![Page 96: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/96.jpg)
Vertebral Artery AngiogramVertebral Artery Angiogram
![Page 97: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/97.jpg)
Let’s ReviewLet’s Review
![Page 98: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/98.jpg)
9898
What is the name of this What is the name of this Procedure?Procedure?
What is it done for?What is it done for?
![Page 99: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/99.jpg)
9999
What is the name of this What is the name of this pathology?pathology?
![Page 100: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/100.jpg)
100100
What part of the body is being What part of the body is being imaged?imaged?
What is the pathology is this What is the pathology is this image?image?
![Page 101: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/101.jpg)
101101
![Page 102: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/102.jpg)
102102
What is this method callled?What is this method callled?
![Page 103: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/103.jpg)
103103
A
B
C
![Page 104: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/104.jpg)
Venography Venography 20132013
![Page 105: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/105.jpg)
Venous Venous CirculationCirculation
![Page 106: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/106.jpg)
What is Venography?What is Venography?
Vein study using x-ray and contrast Vein study using x-ray and contrast mediamedia– Fluoroscopy and still imagesFluoroscopy and still images
One of the most accurate tests for One of the most accurate tests for deep vein thrombosis (DVT)deep vein thrombosis (DVT)
Most commonly done in legs for DVTMost commonly done in legs for DVT
![Page 107: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/107.jpg)
Thrombosis and EmbolismThrombosis and Embolism Intravascular clotIntravascular clot Commonly in veins Commonly in veins
more than arteriesmore than arteries
3 factors3 factors– Where blood is slowWhere blood is slow– Change in the wall Change in the wall
of vesselsof vessels– Change in the blood Change in the blood
itselfitself
Thrombus that Thrombus that becomes detached becomes detached from the vessel wallfrom the vessel wall
Can easily flow to Can easily flow to heart causing PEheart causing PE
Severity depends on Severity depends on location of embolismlocation of embolism
![Page 108: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/108.jpg)
Pulmonary EmbolismPulmonary Embolism Occurs when a clot forms or becomes lodged in Occurs when a clot forms or becomes lodged in
the pulmonary arterythe pulmonary artery
Most commonly thrombus originates in the lower Most commonly thrombus originates in the lower limbs and migrateslimbs and migrates
Can lead to resp distress, heart failure or Can lead to resp distress, heart failure or cardiogenic shockcardiogenic shock
Symptoms are acute:Symptoms are acute:– Sudden coughingSudden coughing– SOBSOB– Chest painChest pain
![Page 109: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/109.jpg)
Pulmonary Emboli (PE)Pulmonary Emboli (PE)
![Page 110: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/110.jpg)
IndicationsIndications Diagnose deep vein Diagnose deep vein
thrombosis thrombosis – Prevent pulmonary Prevent pulmonary
embolismembolism
Distinguish blood clots from Distinguish blood clots from obstructions in the veins obstructions in the veins
Evaluate congenital vein Evaluate congenital vein problems problems
Assess the functioning of Assess the functioning of deep leg vein valves deep leg vein valves
Identify a vein for arterial Identify a vein for arterial bypass graftingbypass grafting
![Page 111: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/111.jpg)
Risk Factors and Risk Factors and ComplicationsComplications
Previous thrombosis Previous thrombosis
Dilution of the contrast dye in the Dilution of the contrast dye in the lower limb lower limb
Difficulty accessing the veins due to: Difficulty accessing the veins due to: – ObesityObesity– Severe swelling (edema) Severe swelling (edema) – Inflammation in the cells ( cellulitis ) Inflammation in the cells ( cellulitis )
![Page 112: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/112.jpg)
ContraindicationsContraindications Bleeding disordersBleeding disorders
Allergy to iodineAllergy to iodine
CHFCHF
Severe pulmonary hypertensionSevere pulmonary hypertension
![Page 113: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/113.jpg)
Prior to ProcedurePrior to Procedure Fast or drink only clear fluids for four Fast or drink only clear fluids for four
hours before the testhours before the test
Thorough PT history obtainedThorough PT history obtained
Informed consentInformed consent
If you are nervous about the test, your If you are nervous about the test, your doctor may give you a sedative.doctor may give you a sedative.
![Page 114: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/114.jpg)
During ProcedureDuring Procedure
PT will lie on a tilting x-ray tablePT will lie on a tilting x-ray table
Area of interest will be Area of interest will be shaved and cleaned shaved and cleaned
Local anestheticLocal anesthetic
Catheter will be inserted.Catheter will be inserted.– A small incision may be A small incision may be made in that area as wellmade in that area as well
![Page 115: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/115.jpg)
Explanation of Procedure: Explanation of Procedure: LegsLegs The catheter is inserted The catheter is inserted
into PT veininto PT vein– (usually a vein in the foot) (usually a vein in the foot)
Contrast is slowly injected. Contrast is slowly injected.
A tight band may be tied A tight band may be tied around your ankle and around your ankle and upper thighupper thigh– or your lower body may be or your lower body may be
tiltedtilted– Fluoro and/or x-ray images Fluoro and/or x-ray images
takentaken
The procedure takes about The procedure takes about 30 - 45 minutes 30 - 45 minutes
![Page 116: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/116.jpg)
Post ProcedurePost Procedure Rest and avoid strenuous activityRest and avoid strenuous activity
Increase fluid intakeIncrease fluid intake
Stop bleeding with pressure Stop bleeding with pressure – Call DR if it won’t stop bleedingCall DR if it won’t stop bleeding
Observe for signs of infectionObserve for signs of infection
PT will be sore for a few daysPT will be sore for a few days
Resume normal activity 24 hours after procedureResume normal activity 24 hours after procedure
![Page 117: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/117.jpg)
Possible Post Procedure Possible Post Procedure ComplicationsComplications
Infection at the Infection at the injection site injection site
Tissue damage Tissue damage
Phlebitis Phlebitis (inflammation of a (inflammation of a vein) vein)
Allergic reactions to Allergic reactions to the contrast dye the contrast dye
Congestive heart failure Congestive heart failure
Acute renal insufficiency Acute renal insufficiency
Venous thrombosis in a Venous thrombosis in a healthy leg healthy leg
Dislodging a clot, Dislodging a clot, perhaps resulting in perhaps resulting in pulmonary embolus or pulmonary embolus or other complicationsother complications
![Page 118: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/118.jpg)
Lower Limb VeinsLower Limb Veins
![Page 119: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/119.jpg)
Lower Limb VenogramsLower Limb Venograms To rule out thrombosis of the deep To rule out thrombosis of the deep
veins of the leg veins of the leg – Deep vein thrombosis (DVT)Deep vein thrombosis (DVT)
Contrast media injected in superficial Contrast media injected in superficial veins of the foot with a needleveins of the foot with a needle
![Page 120: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/120.jpg)
Lower Limb Lower Limb VenogramsVenograms
![Page 121: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/121.jpg)
DVTDVT
![Page 122: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/122.jpg)
Inferior VenacavagramInferior Venacavagram Primarily to rule out thrombus or Primarily to rule out thrombus or
occlusionocclusion
Catheter inserted into femoral vein and Catheter inserted into femoral vein and positioned inside the common iliac vein positioned inside the common iliac vein or inferior aspect of inferior vena cavaor inferior aspect of inferior vena cava
Contrast injected at 20 ml/sec for total of Contrast injected at 20 ml/sec for total of 40ml40ml
![Page 123: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/123.jpg)
Upper Limb VeinsUpper Limb Veins
![Page 124: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/124.jpg)
Upper Limb VenogramsUpper Limb Venograms Most often for thrombosis or Most often for thrombosis or
occlusionocclusion Contrast injected in a superficial vein Contrast injected in a superficial vein
in the elbow or wristin the elbow or wrist– Using a catheter or needleUsing a catheter or needle– 40-80ml at a rate of 1-4ml/sec40-80ml at a rate of 1-4ml/sec
![Page 125: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/125.jpg)
Superior VenacavagramSuperior Venacavagram Primarily done to rule out thrombus or Primarily done to rule out thrombus or
occlusionocclusion
Needle or catheter is introduced into Needle or catheter is introduced into antecubital fossaantecubital fossa– Catheter is positioned in the axillary or Catheter is positioned in the axillary or
subclavian vein and contrast is injectedsubclavian vein and contrast is injected– 30-50ml at 10-15ml/sec30-50ml at 10-15ml/sec
X-rays should include:X-rays should include:– Brachicephalic veinBrachicephalic vein– Subclavian veinSubclavian vein– Superior vena cavaSuperior vena cava– RT AtriumRT Atrium
![Page 126: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/126.jpg)
Superior VenacavagramSuperior Venacavagram
![Page 127: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/127.jpg)
Stenosis on a Superior Stenosis on a Superior VenacavogramVenacavogram
![Page 128: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/128.jpg)
Inferior VenacavagramInferior Venacavagram
![Page 129: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/129.jpg)
Inferior VenacavagramInferior Venacavagram
![Page 130: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/130.jpg)
Inferior Vena Cava FiltersInferior Vena Cava Filters
![Page 131: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/131.jpg)
Inferior Vena Cava Filter Inferior Vena Cava Filter PlacementPlacement
Designed to trap Designed to trap thrombus before thrombus before causing an causing an embolizationembolization
When When anticoagulants are anticoagulants are contraindicated contraindicated this can be usedthis can be used
![Page 132: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/132.jpg)
Inferior Vena Cava Filter Inferior Vena Cava Filter PlacementPlacement
![Page 133: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/133.jpg)
![Page 134: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/134.jpg)
Hepatic VenogramHepatic Venogram Performed to rule out stenosis or Performed to rule out stenosis or
thrombus of the hepatic veinsthrombus of the hepatic veins
Obtain pressure measurements of Obtain pressure measurements of the veins inside the liverthe veins inside the liver
Usually catheter enters jugular vein Usually catheter enters jugular vein or upper limb veinsor upper limb veins
![Page 135: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/135.jpg)
Hepatic VenogramHepatic Venogram
![Page 136: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/136.jpg)
Portal VenogramPortal Venogram
![Page 137: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/137.jpg)
Portal SystemPortal System
http://www.youtube.com/watch?v=4aGNqmWOuEo&feature=related
![Page 138: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/138.jpg)
Transjugular Intrahepatic Transjugular Intrahepatic Portosystemic ShuntPortosystemic Shunt
Intervention for Intervention for creating an artificial creating an artificial low-pressure pathwaylow-pressure pathway– Between portal & Between portal &
hepatic veinshepatic veins
Hepatic venogram Hepatic venogram usually preformed usually preformed before placementbefore placement
US also usefulUS also useful http://www.youtube.com/watch?v=pGA6KUgq7AI
![Page 139: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/139.jpg)
139139
![Page 140: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/140.jpg)
Transjugular Intrahepatic Transjugular Intrahepatic Portosystemic ShuntPortosystemic Shunt
![Page 141: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/141.jpg)
Renal VenogramRenal Venogram Rule out thrombosis of renal veinRule out thrombosis of renal vein
Renal vein catheterized to take bloodRenal vein catheterized to take blood– Measure the production of reninMeasure the production of renin– Catheter insertion site: femoral veinCatheter insertion site: femoral vein
Contrast injected 8ml/sec for 16ml totalContrast injected 8ml/sec for 16ml total– 2 images per second for 4 seconds2 images per second for 4 seconds
![Page 142: Circulatory and Cardiovascular Systems](https://reader036.vdocument.in/reader036/viewer/2022062520/56815d12550346895dcb161e/html5/thumbnails/142.jpg)
Renal VenogramRenal Venogram